How can counselling affect pancreatic beta-cell function in patients with type 2 diabetes?

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Posted by on Mar 26, 2023 in Diabetes mellitus |

In a nutshell

This study analyzed the long-term effect of behavioral counseling on increasing daily physical activity (PA) and reducing sedentary (SED) time on changes in beta-cell (β-cell) function and glucose control in patients with type 2 diabetes (T2D). The authors concluded that increasing moderate-to-vigorous-intensity physical activity (MVPA) and reducing SED time can effectively preserve the β-cell function of the pancreas and improve glucose control in these patients.

Some background

β-cells are a type of cells found in the pancreas. They produce and secrete the hormone insulin. Insulin controls blood glucose levels. Patients with T2D have impaired β-cell function, reduced insulin sensitivity, and a progressive decline in the ability to maintain normal glucose levels. It is important to ensure the protection of β-cells and reduce their decline in function.

Evidence suggests that supervised exercise can result in increased β-cell function, depending on duration and intensity. However, routine implementation in clinical practice can be challenging. Based on study results, behavioral counseling may offer a better approach since it involves a sustained change made by patients. There is a need to assess the long-term effects of behavioral counseling on physical activity (PA) or SED-time in relation to β-cell function and glucose control in patients with T2D.

Methods & findings

This study involved 300 patients that had T2D for at least 1 year. Patients randomly received once-monthly theoretical and practical exercise counseling for 3 years or standard care. Standard care included general physician recommendations for increasing PA while reducing SED-time. All patients were given dietary prescriptions to achieve targets based on blood glucose, blood pressure, fats, and body weight. The Homeostatic Model Assessment-2 (HOMA-2) was used to assess β-cell function (HOMA-B%), insulin sensitivity (HOMA-S%), insulin resistance (HOMA-IR), light-intensity physical activity (LPA), and MVPA.

β-cell function (HOMA-B%) decreased for patients given standard care. Patients that received behavioral counseling had stable β-cell function (HOMA-B%). Significant differences were observed between treatment groups for insulin sensitivity and secretion.

The bottom line

The study showed that patients with T2D that had sustained increases in MVPA may have long-term maintenance of β-cell function with better glucose control if there is a decrease in SED time and a switch to LPA.

The fine print

The study only used the HOMA-2 method for assessing β-cell function and insulin sensitivity. Many patients were lost to follow-up. This may affect the results. 

Published By :

Diabetes Research and Clinical Practice

Original Title :

Sustained decreases in sedentary time and increases in physical activity are associated with preservation of estimated β-cell function in individuals with type 2 diabetes.

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